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Franceschi R, Pertile R, Marigliano M, Mozzillo E, Maffeis C, Di Candia F, Fedi L, Iafusco D, Zanfardino A, Passanisi S, Lombardo F, Delvecchio M, Caldarelli G, Troncone A. Maintaining a gluten-free diet is associated with quality of life in youths with type 1 diabetes and celiac disease. Acta Diabetol 2024:10.1007/s00592-024-02281-6. [PMID: 38615127 DOI: 10.1007/s00592-024-02281-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 03/19/2024] [Indexed: 04/15/2024]
Abstract
AIM Conflicting findings have been reported on whether in youths, the double diagnosis of type 1 diabetes (T1D) and celiac disease (CD) substantially impacts quality of life QoL, compared to subjects with T1D only. METHODS In this study, 86 youths with double diagnosis and their parents were compared to 167 subjects with T1D only. QoL was assessed through the KINDL questionnaire. Anti-tissue transglutaminase antibodies and dietary interviews evaluated the degree of maintaining a gluten-free diet (GFD). RESULTS We found that having CD in addition to T1D has little effect on overall QoL. However, analysis of the degree of maintaining GFD revealed significantly lower total QoL scores in groups with T1D + CD not strictly maintaining GFD compared to T1D only (p = 0.0014). The multivariable linear regression model confirmed the importance of maintaining GFD on QoL in subjects (p = 0.0066) and parents (p = 0.023). CONCLUSION The coexistence of T1D and CD and the adoption of a GFD resulted in poor QoL levels, as in youth as in their parents, when difficulties implementing the GFD are present. Psychological support should consider the importance of maintaining GFD not only to prevent potential complications in the future but also to improve actual QoL in different subdomains.
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Affiliation(s)
- Roberto Franceschi
- Department of Pediatrics, S. Chiara Hospital of Trento, APSS, Trentino-Alto Adige, Trento, Italy
| | - Riccardo Pertile
- Clinical and Evaluative Epidemiology Unit, Department of Governance, APSS, Trento, Italy
| | - Marco Marigliano
- Department of Surgery, Dentistry, Pediatrics, and Gynecology, Section of Pediatric Diabetes and Metabolism, University and Azienda Ospedaliera, Universitaria Integrata of Verona, Piazzale Aristide Stefani 1, 37126, Verona, Italy.
| | - Enza Mozzillo
- Department of Translational Medical Science, Section of Pediatrics, Università Degli Studi Di Napoli Federico II, Naples, Italy
| | - Claudio Maffeis
- Department of Surgery, Dentistry, Pediatrics, and Gynecology, Section of Pediatric Diabetes and Metabolism, University and Azienda Ospedaliera, Universitaria Integrata of Verona, Piazzale Aristide Stefani 1, 37126, Verona, Italy
| | - Francesca Di Candia
- Department of Translational Medical Science, Section of Pediatrics, Università Degli Studi Di Napoli Federico II, Naples, Italy
| | - Ludovica Fedi
- Department of Translational Medical Science, Section of Pediatrics, Università Degli Studi Di Napoli Federico II, Naples, Italy
| | - Dario Iafusco
- Department of Woman, Child, and General, and Specialistic Surgery, Regional Center of Pediatric Diabetes, the University of Campania "L. Vanvitelli", Naples, Italy
| | - Angela Zanfardino
- Department of Woman, Child, and General, and Specialistic Surgery, Regional Center of Pediatric Diabetes, the University of Campania "L. Vanvitelli", Naples, Italy
| | - Stefano Passanisi
- Department of Human Pathology of Adulthood and Childhood G. Barresi, University of Messina, Messina, Italy
| | - Fortunato Lombardo
- Department of Human Pathology of Adulthood and Childhood G. Barresi, University of Messina, Messina, Italy
| | - Maurizio Delvecchio
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L'Aquila, Via Vetorio, Coppito 2, L'Aquila, Italy
| | - Gaia Caldarelli
- Department of Psychology, The University of Campania "L. Vanvitelli", Caserta, Italy
| | - Alda Troncone
- Department of Psychology, The University of Campania "L. Vanvitelli", Caserta, Italy
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Franceschi R, Pertile R, Marigliano M, Mozzillo E, Maffeis C, Morotti E, Di Candia F, Fedi L, Iafusco D, Zanfardino A, Cauvin V, Maltoni G, Zucchini S, Cherubini V, Tiberi V, Minuto N, Bassi M, Rabbone I, Savastio S, Tinti D, Tornese G, Schiaffini R, Passanisi S, Lombardo F, Bonfanti R, Scaramuzza A, Troncone A. Satisfaction with continuous glucose monitoring is associated with quality of life in young people with type 1 diabetes regardless of metabolic control and treatment type. Diabet Med 2024:e15307. [PMID: 38383984 DOI: 10.1111/dme.15307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 01/15/2024] [Accepted: 02/03/2024] [Indexed: 02/23/2024]
Abstract
AIMS While continuous glucose monitoring (CGM) and associated technologies have positive effects on metabolic control in young people with type 1 diabetes (T1D), less is known about their impact on quality of life (QoL). Here, we quantified CGM satisfaction and QoL in young people with T1D and their parents/caregivers to establish (i) the relationship between QoL and CGM satisfaction and (ii) the impact of the treatment regimen on QoL. METHODS This was a cross-sectional study of children and adolescents with T1D on different treatment regimens (multiple daily injections, sensor-augmented pumps and automated insulin delivery). QoL was assessed with the KINDL instrument, and CGM satisfaction with the CGM-SAT questionnaire was evaluated in both youths with T1D and their parents. RESULTS Two hundred and ten consecutively enrolled youths with T1D completed the KINDL and CGM-SAT questionnaires. The mean total KINDL score was greater than neutral in both subjects with T1D (3.99 ± 0.47) and parents (4.06 ± 0.40), and lower overall CGM-SAT scores (i.e., higher satisfaction) were significantly associated with higher QoL in all six KINDL subscales (p < 0.05). There were no differences in KINDL scores according to delivery technology or when participants were grouped according to optimal and sub-optimal glucose control. CONCLUSIONS Higher satisfaction with recent CGMs was associated with better QoL in all dimensions. QoL was independent of both the insulin delivery technology and glycaemic control. CGM must be further disseminated. Attention on perceived satisfaction with CGM should be incorporated with the clinical practice to improve the well-being of children and adolescents with T1D and their families.
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Affiliation(s)
- Roberto Franceschi
- Department of Pediatrics, S. Chiara Hospital of Trento, APSS, Trent, Trentino-Alto Adige, Italy
| | - Riccardo Pertile
- Clinical and Evaluative Epidemiology Unit, Department of Governance, APSS, Trent, Italy
| | - Marco Marigliano
- Department of Surgery, Dentistry, Pediatrics and Gynecology, Section of Pediatric Diabetes and Metabolism, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Enza Mozzillo
- Department of Translational Medical Science, Section of Pediatrics, Università degli Studi di Napoli Federico II, Naples, Italy
| | - Claudio Maffeis
- Department of Surgery, Dentistry, Pediatrics and Gynecology, Section of Pediatric Diabetes and Metabolism, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Elisa Morotti
- Department of Surgery, Dentistry, Pediatrics and Gynecology, Section of Pediatric Diabetes and Metabolism, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Francesca Di Candia
- Department of Translational Medical Science, Section of Pediatrics, Università degli Studi di Napoli Federico II, Naples, Italy
| | - Ludovica Fedi
- Department of Translational Medical Science, Section of Pediatrics, Università degli Studi di Napoli Federico II, Naples, Italy
| | - Dario Iafusco
- Department of Woman, Child and General and Specialistic Surgery, Regional Center of Pediatric Diabetes, University of Campania "L. Vanvitelli", Naples, Italy
| | - Angela Zanfardino
- Department of Woman, Child and General and Specialistic Surgery, Regional Center of Pediatric Diabetes, University of Campania "L. Vanvitelli", Naples, Italy
| | - Vittoria Cauvin
- Department of Pediatrics, S. Chiara Hospital of Trento, APSS, Trent, Trentino-Alto Adige, Italy
| | - Giulio Maltoni
- Pediatric Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Stefano Zucchini
- Pediatric Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Valentino Cherubini
- Department of Women's and Children's Health, Azienda Ospedaliero-Universitaria, Ospedali Riuniti di Ancona, 'G. Salesi Hospital', Ancona, Italy
| | - Valentina Tiberi
- Department of Women's and Children's Health, Azienda Ospedaliero-Universitaria, Ospedali Riuniti di Ancona, 'G. Salesi Hospital', Ancona, Italy
| | - Nicola Minuto
- Pediatric Clinic, IRCCS Giannina Gaslini, Genoa, Italy
- Department of Neuroscience Rehabilitation Ophthalmology Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
| | - Marta Bassi
- Pediatric Clinic, IRCCS Giannina Gaslini, Genoa, Italy
- Department of Neuroscience Rehabilitation Ophthalmology Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
| | - Ivana Rabbone
- Division of Pediatrics, Department of Health Sciences, University of Piemonte Orientale, Novara, Italy
| | - Silvia Savastio
- Division of Pediatrics, Department of Health Sciences, University of Piemonte Orientale, Novara, Italy
| | - Davide Tinti
- Center of Pediatric Diabetology, A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy
| | - Gianluca Tornese
- Institute for Maternal and Child Health IRCCS "Burlo Garofolo", Trieste, Italy
| | - Riccardo Schiaffini
- Pediatric Diabetology Department, Bambino Gesu Pediatric Hospital, Rome, Lazio, Italy
| | - Stefano Passanisi
- Department of Human Pathology of Adulthood and Childhood G. Barresi, University of Messina, Messina, Italy
| | - Fortunato Lombardo
- Department of Human Pathology of Adulthood and Childhood G. Barresi, University of Messina, Messina, Italy
| | - Riccardo Bonfanti
- Department of Pediatrics, Diabetes Research Institute, IRCCS San Raffaele, Milan, Italy
| | - Andrea Scaramuzza
- Pediatric Diabetes, Endocrinology and Nutrition, Pediatric Unit, ASST Cremona, Ospedale Maggiore, Cremona, Italy
| | - Alda Troncone
- Department of Psychology, University of Campania "L. Vanvitelli", Caserta, Italy
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Marigliano M, Pertile R, Mozzillo E, Troncone A, Maffeis C, Morotti E, Di Candia F, Fedi L, Iafusco D, Zanfardino A, Cauvin V, Maltoni G, Zucchini S, Cherubini V, Tiberi V, Minuto N, Bassi M, Rabbone I, Savastio S, Tinti D, Tornese G, Schiaffini R, Passanisi S, Lombardo F, Bonfanti R, Scaramuzza A, Franceschi R. Satisfaction with continuous glucose monitoring is positively correlated with time in range in children with type 1 diabetes. Diabetes Res Clin Pract 2023; 204:110895. [PMID: 37673191 DOI: 10.1016/j.diabres.2023.110895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 08/28/2023] [Accepted: 09/04/2023] [Indexed: 09/08/2023]
Abstract
AIMS Continuous glucose monitoring (CGM) can improve glucometrics in children with type 1 diabetes (T1D), and its efficacy is positively related to glucose sensor use for at least 60% of the time. We therefore investigated the relationship between CGM satisfaction as assessed by a robust questionnaire and glucose control in pediatric T1D patients. METHODS This was a cross-sectional study of children and adolescents with T1D using CGM. The CGM Satisfaction (CGM-SAT) questionnaire was administered to patients and demographic, clinical, and glucometrics data were recorded. RESULTS Two hundred and ten consecutively enrolled patients attending 14 Italian pediatric diabetes clinics completed the CGM-SAT questionnaire. CGM-SAT scores were not associated with age, gender, annual HbA1c, % of time with an active sensor, time above range (TAR), time below range (TBR), and coefficient of variation (CV). However, CGM satisfaction was positively correlated with time in range (TIR, p < 0.05) and negatively correlated with glycemia risk index (GRI, p < 0.05). CONCLUSIONS CGM seems to have a positive effect on glucose control in patients with T1D. CGM satisfaction is therefore an important patient-reported outcome to assess and it is associated with increased TIR and reduced GRI.
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Affiliation(s)
- Marco Marigliano
- Department of Surgery, Dentistry, Pediatrics and Gynecology, Section of Pediatric Diabetes and Metabolism, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Riccardo Pertile
- Clinical and Evaluative Epidemiology Unit, Department of Governance, APSS, Trento, Italy
| | - Enza Mozzillo
- Department of Translational Medical Science, Section of Pediatrics, Università degli Studi di Napoli Federico II, Naples, Italy
| | - Alda Troncone
- Department of Psychology, University of Campania "L. Vanvitelli", Caserta, Italy
| | - Claudio Maffeis
- Department of Surgery, Dentistry, Pediatrics and Gynecology, Section of Pediatric Diabetes and Metabolism, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Elisa Morotti
- Department of Surgery, Dentistry, Pediatrics and Gynecology, Section of Pediatric Diabetes and Metabolism, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Francesca Di Candia
- Department of Translational Medical Science, Section of Pediatrics, Università degli Studi di Napoli Federico II, Naples, Italy
| | - Ludovica Fedi
- Department of Translational Medical Science, Section of Pediatrics, Università degli Studi di Napoli Federico II, Naples, Italy
| | - Dario Iafusco
- Department of Woman, Child and General and Specialistic Surgery, Regional Center of Pediatric Diabetes, University of Campania "L. Vanvitelli", Naples, Italy
| | - Angela Zanfardino
- Department of Woman, Child and General and Specialistic Surgery, Regional Center of Pediatric Diabetes, University of Campania "L. Vanvitelli", Naples, Italy
| | - Vittoria Cauvin
- Department of Pediatrics, S.Chiara Hospital of Trento, APSS, Trento, Trentino-Alto Adige, Italy
| | - Giulio Maltoni
- Pediatric Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Stefano Zucchini
- Pediatric Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Valentino Cherubini
- Department of Women's and Children's Health, Azienda Ospedaliero-Universitaria, Ospedali Riuniti di Ancona, "G. Salesi Hospital", Ancona, Italy
| | - Valentina Tiberi
- Department of Women's and Children's Health, Azienda Ospedaliero-Universitaria, Ospedali Riuniti di Ancona, "G. Salesi Hospital", Ancona, Italy
| | - Nicola Minuto
- Pediatric Clinic, IRCCS Giannina Gaslini, Department of Neuroscience Rehabilitation Ophtalmology Genetics, Maternal and Child Health, University of Genoa, Genova, Italy
| | - Marta Bassi
- Pediatric Clinic, IRCCS Giannina Gaslini, Department of Neuroscience Rehabilitation Ophtalmology Genetics, Maternal and Child Health, University of Genoa, Genova, Italy
| | - Ivana Rabbone
- Division of Pediatrics, Department of Health Sciences, University of Piemonte Orientale, Novara, Italy
| | - Silvia Savastio
- Division of Pediatrics, Department of Health Sciences, University of Piemonte Orientale, Novara, Italy
| | - Davide Tinti
- Center of Pediatric Diabetology-A.O.U. Città della Salute e della Scienza di Torino, Torino, Italy
| | - Gianluca Tornese
- Institute for Maternal and Child Health IRCCS "Burlo Garofolo", Trieste, Italy
| | - Riccardo Schiaffini
- Pediatric Diabetology Department, Bambino Gesu Pediatric Hospital Roma, Lazio, Italy
| | - Stefano Passanisi
- Department of Human Pathology of Adulthood and Childhood G. Barresi, University of Messina, Messina, Italy
| | - Fortunato Lombardo
- Department of Human Pathology of Adulthood and Childhood G. Barresi, University of Messina, Messina, Italy
| | - Riccardo Bonfanti
- Department of Pediatrics, Diabetes Research Institute, IRCCS San Raffaele, Milano, Italy
| | - Andrea Scaramuzza
- Pediatric Diabetes, Endocrinology and Nutrition, Pediatric Unit, ASST Cremona, Ospedale Maggiore, Cremona, Italy.
| | - Roberto Franceschi
- Department of Pediatrics, S.Chiara Hospital of Trento, APSS, Trento, Trentino-Alto Adige, Italy
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Troncone A, Affuso G, Cascella C, Chianese A, Zanfardino A, Iafusco D. Prevalence and Multidimensional Model of Disordered Eating in Youths With Type 1 Diabetes: Results From a Nationwide Population-Based Study. J Pediatr Psychol 2023; 48:731-739. [PMID: 36921286 DOI: 10.1093/jpepsy/jsad016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 02/24/2023] [Accepted: 02/27/2023] [Indexed: 03/17/2023] Open
Abstract
OBJECTIVE The aim of this study was to report nationwide data of the prevalence of disordered eating behaviors (DEBs) in adolescents with type 1 diabetes (T1D) and to evaluate a multidimensional model of eating problems, analyzing how psychopathological problems are associated with DEBs and with metabolic control. METHODS This study was carried out using a cross-sectional design with a sample of 1,562 patients with T1D (812 male), aged 11-19 years. Participants were recruited from multiple pediatric diabetes centers (N = 30) located in northern, central, and southern Italy, and they individually completed the Diabetes Eating Problem Survey-Revised (DEPS-r) and the Youth Self-Report (YSR). Sociodemographic and clinical data were also gathered. Multiple-group structural equation modeling was used to investigate the relationships between internalizing/externalizing symptoms, DEBs, and glycosylated hemoglobin (HbA1c) values. RESULTS A total of 29.7% of the participants reported DEBs (DEPS-r scores ≥20), 42.4% reported insulin manipulation (IM). The prevalence of DEBs was higher for female participants (p ≤ .001). The model explains 37% of the variance in disordered eating, 12% in IM, and 21% in HbA1c values. Body mass index, externalizing symptoms, and internalizing symptoms were significantly and positively associated with DEBs, which in turn were significantly and positively associated with HbA1c values (all p ≤ .001). Externalizing (p ≤ .001) and internalizing (p ≤ .01) symptoms were also directly associated with HbA1c values. CONCLUSION Given the relevant prevalence of DEBs, their significant positive association with psychopathological symptoms, and their relationship with worse diabetes outcomes, regular psychological screening and support is needed to ensure the best care of adolescents with T1D.
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Affiliation(s)
- Alda Troncone
- Department of Psychology, University of Campania "Luigi Vanvitelli", Italy
| | - Gaetana Affuso
- Department of Psychology, University of Campania "Luigi Vanvitelli", Italy
| | - Crescenzo Cascella
- Department of Psychology, University of Campania "Luigi Vanvitelli", Italy
| | | | - Angela Zanfardino
- Department of the Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Italy
| | - Dario Iafusco
- Department of the Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Italy
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Mozzillo E, Marigliano M, Troncone A, Maffeis C, Morotti E, Di Candia F, Fedi L, Iafusco D, Zanfardino A, Cauvin V, Pertile R, Maltoni G, Zucchini S, Cherubini V, Tiberi V, Minuto N, Bassi M, Rabbone I, Savastio S, Tinti D, Tornese G, Schiaffini R, Passanisi S, Lombardo F, Bonfanti R, Scaramuzza A, Franceschi R. Italian translation and validation of the CGM satisfaction scale questionnaire. Acta Diabetol 2023; 60:673-679. [PMID: 36808474 DOI: 10.1007/s00592-023-02043-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 01/27/2023] [Indexed: 02/23/2023]
Abstract
AIMS Patient-reported outcomes (PROs) are increasingly important for assessing patient satisfaction with diabetes technologies. PROs must be assessed with validated questionnaires in clinical practice and research studies. Our aim was to translate and validate the Italian version of the continuous glucose monitoring (CGM) Satisfaction (CGM-SAT) scale questionnaire. METHODS Questionnaire validation followed MAPI Research Trust guidelines and included forward translation, reconciliation, backward translation, and cognitive debriefing. RESULTS The final version of the questionnaire was administered to 210 patients with type 1 diabetes (T1D) and 232 parents. The completion rate was excellent, with almost 100% of items answered. The overall Cronbach's coefficient was 0.71 and 0.85 for young people (patients) and parents indicating moderate and good internal consistency, respectively. Parent-young people agreement was 0.404 (95% confidence interval: 0.391-0.417), indicating moderate agreement between the two assessments. Factor analysis identified that factors assessing the "benefits" and "hassles" of CGM accounted for 33.9% and 12.9% of score variance in young people and 29.6% and 19.8% in parents, respectively. DISCUSSION We present the successful Italian translation and validation of the CGM-SAT scale questionnaire, which will be useful for assessing satisfaction with Italian T1D patients using CGM systems.
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Affiliation(s)
- Enza Mozzillo
- Department of Translational Medical Science, Section of Pediatrics, Università Degli Studi Di Napoli Federico II, Naples, Italy
| | - Marco Marigliano
- Department of Surgery, Dentistry, Pediatrics and Gynecology, Section of Pediatric Diabetes and Metabolism, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Alda Troncone
- Department of Woman, Child and General and Specialistic Surgery, Regional Center of Pediatric Diabetes, University of Campania "L. Vanvitelli", Naples, Italy
| | - Claudio Maffeis
- Department of Surgery, Dentistry, Pediatrics and Gynecology, Section of Pediatric Diabetes and Metabolism, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Elisa Morotti
- Department of Surgery, Dentistry, Pediatrics and Gynecology, Section of Pediatric Diabetes and Metabolism, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Francesca Di Candia
- Department of Translational Medical Science, Section of Pediatrics, Università Degli Studi Di Napoli Federico II, Naples, Italy
| | - Ludovica Fedi
- Department of Translational Medical Science, Section of Pediatrics, Università Degli Studi Di Napoli Federico II, Naples, Italy
| | - Dario Iafusco
- Department of Woman, Child and General and Specialistic Surgery, Regional Center of Pediatric Diabetes, University of Campania "L. Vanvitelli", Naples, Italy
| | - Angela Zanfardino
- Department of Woman, Child and General and Specialistic Surgery, Regional Center of Pediatric Diabetes, University of Campania "L. Vanvitelli", Naples, Italy
| | - Vittoria Cauvin
- Department of Pediatrics, S.Chiara Hospital of Trento, APSS, Trento, Trentino-Alto Adige, Italy
| | - Riccardo Pertile
- Clinical and Evaluative Epidemiology Unit, Department of Governance, APSS, Trento, Italy
| | - Giulio Maltoni
- Pediatric Unit, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
| | - Stefano Zucchini
- Pediatric Unit, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
| | - Valentino Cherubini
- Department of Women's and Children's Health, Azienda Ospedaliero-Universitaria, Ospedali Riuniti Di Ancona, "G. Salesi Hospital", Ancona, Italy
| | - Valentina Tiberi
- Department of Women's and Children's Health, Azienda Ospedaliero-Universitaria, Ospedali Riuniti Di Ancona, "G. Salesi Hospital", Ancona, Italy
| | - Nicola Minuto
- Pediatric Clinic, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Marta Bassi
- Pediatric Clinic, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Ivana Rabbone
- Division of Pediatrics, Department of Health Sciences, University of Piemonte Orientale, Novara, Italy
| | - Silvia Savastio
- Division of Pediatrics, Department of Health Sciences, University of Piemonte Orientale, Novara, Italy
| | - Davide Tinti
- Center of Pediatric Diabetology- A.O.U. Città della Salute e della Scienza di Turin, Turin, Italy
| | - Gianluca Tornese
- Institute for Maternal and Child Health IRCCS "Burlo Garofolo", Trieste, Italy
| | - Riccardo Schiaffini
- Pediatric Diabetology Department, Bambino Gesu Pediatric Hospital Roma, Lazio, Italy
| | - Stefano Passanisi
- Department of Human Pathology of Adulthood and Childhood G. Barresi, University of Messina, Messina, Italy
| | - Fortunato Lombardo
- Department of Human Pathology of Adulthood and Childhood G. Barresi, University of Messina, Messina, Italy
| | - Riccardo Bonfanti
- Department of Pediatrics, Diabetes Research Institute, IRCCS San Raffaele, Milan, Italy
| | - Andrea Scaramuzza
- Pediatric Diabetes, Endocrinology and Nutrition, Pediatric Unit, ASST Cremona, Ospedale Maggiore, Viale Concordia 1, 26100, Cremona, Italy.
| | - Roberto Franceschi
- Department of Pediatrics, S.Chiara Hospital of Trento, APSS, Trento, Trentino-Alto Adige, Italy
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Troncone A, Cascella C, Chianese A, Zanfardino A, Pizzini B, Iafusco D. Psychological consequences of the COVID-19 pandemic in people with type 1 diabetes: A systematic literature review. J Psychosom Res 2023; 168:111206. [PMID: 36913765 PMCID: PMC9972771 DOI: 10.1016/j.jpsychores.2023.111206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 02/13/2023] [Accepted: 02/25/2023] [Indexed: 03/02/2023]
Abstract
OBJECTIVE A comprehensive picture of the data on the impact of COVID-19 on the mental health of individuals with type 1 diabetes (T1D) is currently lacking. The purpose of this systematic review was to synthesize extant literature reporting on the effects of COVID-19 on psychological outcomes in individuals with T1D and to identify associated factors. METHODS A systematic search was conducted with PubMed, Scopus, PychInfo, PsycArticles, ProQuest, and WoS using a selection procedure according to the PRISMA methodology. Study quality was assessed using a modified Newcastle-Ottawa Scale. In all, 44 studies fulfilling the eligibility criteria were included. RESULTS Findings suggest that during the COVID-19 pandemic, people with T1D had impaired mental health, with relatively high rates of symptoms of depression (11.5-60.7%, n = 13 studies), anxiety (7-27.5%, n = 16 studies), and distress (14-86.6%, n = 21 studies). Factors associated with psychological problems include female gender, lower income, poorer diabetes control, difficulties in diabetes self-care behaviors, and complications. Of the 44 studies, 22 were of low methodological quality. CONCLUSIONS Taking appropriate measures to improve medical and psychological services is needed to support individuals with T1D in appropriately coping with the burden and difficulties caused by the COVID-19 pandemic and to prevent mental health problems from enduring, worsening, or having a long-term impact on physical health outcomes. Heterogeneity in measurement methods, lack of longitudinal data, the fact that most included studies did not aim to make a specific diagnosis of mental disorders limit the generalizability of the findings and have implications for practice.
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Affiliation(s)
- Alda Troncone
- Department of Psychology, University of Campania "Luigi Vanvitelli", 81100, Viale Ellittico 31, Caserta, Italy
| | - Crescenzo Cascella
- Department of Psychology, University of Campania "Luigi Vanvitelli", 81100, Viale Ellittico 31, Caserta, Italy
| | - Antonietta Chianese
- Department of Psychology, University of Campania "Luigi Vanvitelli", 81100, Viale Ellittico 31, Caserta, Italy
| | - Angela Zanfardino
- Department of the Woman, of the Child and of the General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Via L. De Crecchio 2, 80138 Naples, Italy.
| | - Barbara Pizzini
- Department of Psychology, University of Campania "Luigi Vanvitelli", 81100, Viale Ellittico 31, Caserta, Italy
| | - Dario Iafusco
- Department of the Woman, of the Child and of the General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Via L. De Crecchio 2, 80138 Naples, Italy
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Zanfardino A, Piscopo A, Gizzone P, Vitulano C, Di Gennaro F, Buccella G, Fabozzi I, Mainolfi G, Marongiu MB, Rollato AS, Testa V, Chianese A, Miraglia Del Giudice E, Troncone A, Iafusco D. Adolescents with type 1 diabetes vs. hybrid closed loop systems: a case series of patients' behaviour that challenges the algorithm. J Pediatr Endocrinol Metab 2023; 36:216-222. [PMID: 36511758 DOI: 10.1515/jpem-2022-0411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 11/17/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVES Hybrid closed loop systems (HCL) improve the management of type 1 diabetes (T1DM). T1DM adolescent patients represent a risk category also if they are in an automated insulin infusion delivery therapy. CASE PRESENTATION We describe a series of four cases in which adolescent patients have adopted incorrect behaviours in the managing of HCL systems, challenging the algorithm skills. Two patients performed fabricated sensor calibrations. The other two did not perform pre-prandial insulin boluses correctly. Despite these behaviours, the algorithm corrected the glucose values in three out of four patients. Only in one case, where fabricated calibrations were too frequent, the automatic system failed to restore the glycemic balance. CONCLUSIONS Fabricated calibrations seem to be more important than uncorrected insulin boluses to challenge the HCL systems.
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Affiliation(s)
- Angela Zanfardino
- Department of Pediatrics, Regional Center for Pediatric Diabetes, University of the Study of Campania, Naples, Italy
| | - Alessia Piscopo
- Department of Pediatrics, Regional Center for Pediatric Diabetes, University of the Study of Campania, Naples, Italy
| | - Pietro Gizzone
- Department of Pediatrics, Regional Center for Pediatric Diabetes, University of the Study of Campania, Naples, Italy
| | - Caterina Vitulano
- Department of Pediatrics, Regional Center for Pediatric Diabetes, University of the Study of Campania, Naples, Italy
| | - Federica Di Gennaro
- Department of Pediatrics, Regional Center for Pediatric Diabetes, University of the Study of Campania, Naples, Italy
| | - Giulia Buccella
- Department of Pediatrics, Regional Center for Pediatric Diabetes, University of the Study of Campania, Naples, Italy
| | - Irma Fabozzi
- Department of Pediatrics, Regional Center for Pediatric Diabetes, University of the Study of Campania, Naples, Italy
| | - Gabriella Mainolfi
- Department of Pediatrics, Regional Center for Pediatric Diabetes, University of the Study of Campania, Naples, Italy
| | - Mariagrazia Bathilde Marongiu
- Department of Pediatrics, Regional Center for Pediatric Diabetes, University of the Study of Campania, Naples, Italy
| | - Assunta S Rollato
- Department of Pediatrics, Regional Center for Pediatric Diabetes, University of the Study of Campania, Naples, Italy
| | - Veronica Testa
- Department of Pediatrics, Regional Center for Pediatric Diabetes, University of the Study of Campania, Naples, Italy
| | - Antonietta Chianese
- Department of Pediatrics, Regional Center for Pediatric Diabetes, University of the Study of Campania, Naples, Italy
| | - Emanuele Miraglia Del Giudice
- Department of Pediatrics, Regional Center for Pediatric Diabetes, University of the Study of Campania, Naples, Italy
| | - Alda Troncone
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | - Dario Iafusco
- Department of Pediatrics, Regional Center for Pediatric Diabetes, University of the Study of Campania, Naples, Italy
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8
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Troncone A, Affuso G, Cascella C, Chianese A, Pizzini B, Zanfardino A, Iafusco D. Prevalence of disordered eating behaviors in adolescents with type 1 diabetes: Results of multicenter Italian nationwide study. Int J Eat Disord 2022; 55:1108-1119. [PMID: 35751499 PMCID: PMC9544556 DOI: 10.1002/eat.23764] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 06/09/2022] [Accepted: 06/10/2022] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To assess the prevalence of disordered eating behaviors (DEBs) in a large sample of Italian adolescents with type 1 diabetes and to explore potential demographic, clinical, and psychological differences (understood as emotional and behavioral problems) among adolescents with and without DEBs. METHOD Adolescents (11-19 years) with type 1 diabetes completed the Diabetes Eating Problems Survey-revised (DEPS-r) and the Youth Self Report (YSR). Demographic and clinical data were also collected. RESULTS Of 690 adolescents with type 1 diabetes (mean age 14.97 ± 1.81, n = 337 girls) assessed in this study, 28.1% (21% boys, 35% girls) were DEPS-r positive (score ≥ 20). Girls had higher DEPS-r total scores (p < .0001, d = .42) than boys, although no age differences were found in mean DEPS-r total scores (p = .961). In both genders, adolescents with DEBs had significantly higher zBMI (p < .0001, d = .52) and HbA1c values (p < .0001, d = .54) and showed more emotional and behavioral problems (both as internalizing and externalizing problems) than those without DEBs (all p < .0001). These differences were largely confirmed in all age groups. Adolescents reporting insulin misuse had higher HbA1c values (p = .001, d = .26), higher DEPS-r mean scores (p < .0001, d = 1.07), and greater psychological problems (all p < .001) than those who did not. DISCUSSION DEBs are prevalent among adolescents with type 1 diabetes, and those with eating problems showed adverse clinical and psychological conditions. Routine screening for DEBs and of general psychological condition should be a fundamental part of diabetes care, especially during adolescence. PUBLIC SIGNIFICANCE STATEMENT This nationwide study indicated that DEBs are common in adolescents with T1D, and those suffering from them show poorer clinical conditions and higher emotional and behavioral problems. As such, it offers important contributions for those working with EDs and in the T1D field, as it provides a deeper understanding of the co-occurring DEBs-emotional/behavioral problems in youths with T1D and highlights the importance of continuous monitoring of their psychological condition by a multidisciplinary team.
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Affiliation(s)
- Alda Troncone
- Department of PsychologyUniversity of Campania “Luigi Vanvitelli”CasertaItaly
| | - Gaetana Affuso
- Department of PsychologyUniversity of Campania “Luigi Vanvitelli”CasertaItaly
| | - Crescenzo Cascella
- Department of PsychologyUniversity of Campania “Luigi Vanvitelli”CasertaItaly
| | - Antonietta Chianese
- Department of PsychologyUniversity of Campania “Luigi Vanvitelli”CasertaItaly
| | - Barbara Pizzini
- Department of PsychologyUniversity of Campania “Luigi Vanvitelli”CasertaItaly
| | - Angela Zanfardino
- Department of the Woman, of the Child and of the General and Specialized SurgeryUniversity of Campania “Luigi Vanvitelli”NaplesItaly
| | - Dario Iafusco
- Department of the Woman, of the Child and of the General and Specialized SurgeryUniversity of Campania “Luigi Vanvitelli”NaplesItaly
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Troncone A, Chianese A, Cascella C, Zanfardino A, Piscopo A, Rollato S, Iafusco D. Eating Problems in Youths with Type 1 Diabetes During and After Lockdown in Italy: An 8-Month Follow-Up Study. J Clin Psychol Med Settings 2022; 30:227-237. [PMID: 35635607 PMCID: PMC9148941 DOI: 10.1007/s10880-022-09884-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2022] [Indexed: 01/09/2023]
Abstract
AbstractEighty-five youths with T1D and 176 controls aged 8–19 years were asked to complete online questionnaires (ChEAT and EAT-26) measuring disordered eating behaviors (DEBs) during (baseline) and after (8-month follow-up) the lockdown. DEB symptoms in all participants (especially younger than 13 years), glycemic control, and zBMI were found unchanged from baseline to follow-up (all p > .05). After 8 months, the ChEAT/EAT-26 critical score frequency decreased significantly in controls (p = .004), as was the score for the ChEAT/EAT-26’s Oral Control subscale in both groups (T1D: p = .005; controls: p = .01). Participants with T1D, especially those older than 13 years, had higher ChEAT/EAT-26 Dieting scores (p = .037) and lower ChEAT/EAT-26 Oral Control scores (p = .046) than controls. Unchanged DEB symptoms suggest that the COVID-19 restrictions did not significantly affect participants’ eating behaviors and that a general adaptation to the challenges of lockdown and other pandemic containment measures occurred in both T1D and control participants.
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Affiliation(s)
- Alda Troncone
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | - Antonietta Chianese
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | - Crescenzo Cascella
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | - Angela Zanfardino
- Department of the Woman, of the Child and of the General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Via L. De Crecchio 2, 80138, Naples, Italy.
| | - Alessia Piscopo
- Department of the Woman, of the Child and of the General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Via L. De Crecchio 2, 80138, Naples, Italy
| | - Serena Rollato
- Department of the Woman, of the Child and of the General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Via L. De Crecchio 2, 80138, Naples, Italy
| | - Dario Iafusco
- Department of the Woman, of the Child and of the General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Via L. De Crecchio 2, 80138, Naples, Italy
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10
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Ozen G, Zanfardino A, Ozen G, Acan B, Piscopo A, Casaburo F, Gicchino F, Confetto S, Troncone A, Iafusco D. Comparison of emotional approaches of medical doctors against COVID-19 pandemic: Eastern and Western Mediterranean countries. Int J Clin Pract 2021; 75:e14973. [PMID: 34626512 PMCID: PMC8646585 DOI: 10.1111/ijcp.14973] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 10/04/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Pandemics are states of disease that occur worldwide and sharply increase in populations. It causes life events which trigger anxiety, depression, anger, sleep deprivation, emotional distress and stress. World Health Organization (WHO) declared coronavirus disease 2019 (COVID-19) a pandemic on March 11, pointing to the over 118,000 cases in over 110 countries. Many healthcare workers became ill during the pandemic and some among them died. In this study, we aimed to evaluate and compare level of stress against COVID-19 pandemic among doctors from Turkey and Italy. METHODS This research is a cross-sectional study in which Perceived Stress Scale (PSS-10) and Secondary Traumatic Stress Scale (STSS) are administered online via social networks. All data collection tools were delivered to individuals between 1 and 15 June 2020 and filled in online with Google Forms application. In total, 618 individuals were included in this study and all of them were medical doctors. RESULTS Higher PS and STS levels were found related to female gender, being married, working in pandemic hospital and older ages. Stress levels were found statistically higher in Turkish doctors when compared to Italian doctors for both stress scales (Turkish/Italian PSS:20.18 ± 7.90/ 19.35 ± 6.71, STSS: 44.19 ± 13.29/ 38.83 ± 13.74). CONCLUSION The number of doctors per 1000 of population is lower and per capita visits to a physician are higher in Turkey when compared to Italy. Besides pandemic, these heavier working conditions, increased weekly working hours can cause stress for Turkish doctors. Reporting information such this study is important and international collaborations are essential to plan future prevention strategies. We need to strengthen international ties and build more international collaborations rather than staying within our national silos. Additionally, interventions to promote mental well-being in health care professionals exposed to COVID-19 need to be immediately implemented.
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Affiliation(s)
- Gulsum Ozen
- Department of PediatricsUniversity of Health ScienceKecioren Training and Research HospitalAnkaraTurkey
| | - Angela Zanfardino
- Regional Centre for Pediatric DiabetesDepartment of PediatricsUniversity of Campania “Luigi Vanvitelli”NaplesItaly
| | - Gulsah Ozen
- Department of Emergency MedicineAtaturk Chest Diseases and Thoracic Surgery Training and Research HospitalAnkaraTurkey
| | - Burak Acan
- Department of Emergency MedicineHacettepe UniversityAnkaraTurkey
| | - Alessia Piscopo
- Regional Centre for Pediatric DiabetesDepartment of PediatricsUniversity of Campania “Luigi Vanvitelli”NaplesItaly
| | - Francesca Casaburo
- Regional Centre for Pediatric DiabetesDepartment of PediatricsUniversity of Campania “Luigi Vanvitelli”NaplesItaly
| | - Francesca Gicchino
- Regional Centre for Pediatric DiabetesDepartment of PediatricsUniversity of Campania “Luigi Vanvitelli”NaplesItaly
| | - Santino Confetto
- Regional Centre for Pediatric DiabetesDepartment of PediatricsUniversity of Campania “Luigi Vanvitelli”NaplesItaly
| | - Alda Troncone
- Regional Centre for Pediatric DiabetesDepartment of PediatricsUniversity of Campania “Luigi Vanvitelli”NaplesItaly
| | - Dario Iafusco
- Regional Centre for Pediatric DiabetesDepartment of PediatricsUniversity of Campania “Luigi Vanvitelli”NaplesItaly
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Troncone A, Chianese A, Cascella C, Zanfardino A, Iafusco D. Psychological Outcomes in Children and Early Adolescents With Type 1 Diabetes Following Pediatric Diabetes Summer Camp: A 3-Month Follow-Up Study. Front Pediatr 2021; 9:650201. [PMID: 33777869 PMCID: PMC7987815 DOI: 10.3389/fped.2021.650201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 02/05/2021] [Indexed: 01/09/2023] Open
Abstract
Objective: The aim of this study was to assess general psychosocial adjustment to diabetes and perceived disease management among patients with type 1 diabetes (T1D) and their parents before and after patients' participation in a diabetes summer camp. Methods: In this follow-up study, 20 children and adolescents with T1D (eight boys; mean age = 11.01 ± 0.94 years; mean diabetes duration = 3.02 ± 2.27) attending a southern Italian diabetic center, along with their parents, were assessed prior to and 3 months after the youths participated in a 1 week camp-based intervention involving didactic and interactive child-centered education and recreational activities. Patients and their parents completed measures assessing patients' quality of life and strategies employed by patients to cope with pain. Patients also completed measures evaluating their diabetes psychosocial adjustment, diabetes self-efficacy management, and illness perception; also, their parents completed measures of caregivers' perceived diabetes burden and treatment satisfaction. Youths' glycated hemoglobin (HbA1c) and standardized body mass index (z-BMI) values were also assessed. Within-subjects repeated-measures analyses of variance evaluated pre- and post-camp changes. Results: Camp attendance showed no beneficial effects on glycemic control, as indicated by HbA1c values both before (7.02%) and after (7.28%) camp being lower than 7.5%. HbA1c values were found to have increased after camp (pre-camp = 7.02%, post-camp = 7.28%; p = 0.010), but since they still fell within an acceptable range, they did not reveal clinically relevant changes in glycemic control. No substantial significant improvement in psychosocial measures was observed in children or parents (all p > 0.05). According to the parents' evaluation, social support-seeking as a patient pain-coping strategy was slightly increased (p = 0.044) after attending the camp. Conclusions: This study does not provide empirical evidence of benefits of participating in a diabetes camp for either patients or their parents. These findings suggest that healthcare providers rethink such camps as an experience for youths with T1D that actively involves parents and that includes both youth- and parent-focused psychological interventions.
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Affiliation(s)
- Alda Troncone
- Department of Psychology, University of Campania "L. Vanvitelli", Caserta, Italy
| | - Antonietta Chianese
- Department of Psychology, University of Campania "L. Vanvitelli", Caserta, Italy
| | - Crescenzo Cascella
- Department of Psychology, University of Campania "L. Vanvitelli", Caserta, Italy
| | - Angela Zanfardino
- Department of the Woman, Child and General and Specialized Surgery, University of Campania "L. Vanvitelli", Naples, Italy
| | - Dario Iafusco
- Department of the Woman, Child and General and Specialized Surgery, University of Campania "L. Vanvitelli", Naples, Italy
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12
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Troncone A, Chianese A, Zanfardino A, Cascella C, Piscopo A, Borriello A, Rollato S, Casaburo F, Testa V, Iafusco D. Disordered eating behaviors in youths with type 1 diabetes during COVID-19 lockdown: an exploratory study. J Eat Disord 2020; 8:76. [PMID: 33292623 PMCID: PMC7708884 DOI: 10.1186/s40337-020-00353-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 11/20/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Recent research indicates that patients with type 1 diabetes (T1D) are at higher risk for disordered eating behaviors (DEBs) than their peers without diabetes. The present study aimed to explore the prevalence of DEBs in a sample of Italian children and adolescents with T1D and in matched-pair healthy controls during the COVID-19 lockdown. METHODS In a cross-sectional study, 138 children and adolescents with T1D (aged 8.01-19.11 years, 65 boys) attending a Southern Italian diabetic service and 276 age- and gender-matched healthy peers voluntarily completed an online survey about eating behaviors (ChEAT and EAT-26), anthropometric characteristics, and clinical characteristics. RESULTS 8.69% (N = 12) of participants with T1D and 13.4% (N = 37) of controls had ChEAT/EAT-26 scores indicating presence of DEBs, with no differences between patients-whether children (total ChEAT score F(1, 157) = .104, p = .748) or adolescents (total EAT-26 score F(1, 255) = .135, p = .731)-and healthy peers. zBMI values were lower than those measured in the latest diabetes visit (p < .0001), while HbA1c values remained unchanged (p = .110). In both groups, adolescents had lower Oral Control scores than children (T1D: F(1, 138) = 20.411, p < .0001, η2 = .132, controls: F(1, 276) = 18.271, p < .0001, η2 = .063); additionally, gender (female) and age were found to be significant predictors of several ChEAT/EAT-26 scores. CONCLUSIONS This exploratory study suggested that children and adolescents with T1D did not experience more DEB symptoms during the COVID-19 lockdown compared to healthy controls. Results revealed DEBs as more of a female adolescent developmental issue rather than a result of the challenges of living with a chronic illness under quarantine measures. Possible effects of parental pressure on their children's eating behaviors in the context of home confinement and of using a non-diabetes-specific measure to assess DEBs are discussed.
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Affiliation(s)
- Alda Troncone
- University of Campania "Luigi Vanvitelli", Caserta, Italy.
- Department of Psychology, University of Campania "Luigi Vanvitelli", Viale Ellittico 31, Caserta, Italy.
| | - Antonietta Chianese
- University of Campania "Luigi Vanvitelli", Caserta, Italy
- Department of Psychology, University of Campania "Luigi Vanvitelli", Viale Ellittico 31, Caserta, Italy
| | - Angela Zanfardino
- University of Campania "Luigi Vanvitelli", Caserta, Italy
- Department of the Woman, of the Child and of the General and Specialized Surgery, Napoli, Italy
| | - Crescenzo Cascella
- University of Campania "Luigi Vanvitelli", Caserta, Italy
- Department of Psychology, University of Campania "Luigi Vanvitelli", Viale Ellittico 31, Caserta, Italy
| | - Alessia Piscopo
- University of Campania "Luigi Vanvitelli", Caserta, Italy
- Department of the Woman, of the Child and of the General and Specialized Surgery, Napoli, Italy
| | - Anna Borriello
- University of Campania "Luigi Vanvitelli", Caserta, Italy
- Department of Psychology, University of Campania "Luigi Vanvitelli", Viale Ellittico 31, Caserta, Italy
| | - Serena Rollato
- University of Campania "Luigi Vanvitelli", Caserta, Italy
- Department of the Woman, of the Child and of the General and Specialized Surgery, Napoli, Italy
| | - Francesca Casaburo
- University of Campania "Luigi Vanvitelli", Caserta, Italy
- Department of the Woman, of the Child and of the General and Specialized Surgery, Napoli, Italy
| | - Veronica Testa
- University of Campania "Luigi Vanvitelli", Caserta, Italy
- Department of the Woman, of the Child and of the General and Specialized Surgery, Napoli, Italy
| | - Dario Iafusco
- University of Campania "Luigi Vanvitelli", Caserta, Italy
- Department of the Woman, of the Child and of the General and Specialized Surgery, Napoli, Italy
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13
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Troncone A, Cascella C, Chianese A, Zanfardino A, Piscopo A, Borriello A, Casaburo F, Del Giudice EM, Iafusco D. Body Image Problems and Disordered Eating Behaviors in Italian Adolescents With and Without Type 1 Diabetes: An Examination With a Gender-Specific Body Image Measure. Front Psychol 2020; 11:556520. [PMID: 33071880 PMCID: PMC7538612 DOI: 10.3389/fpsyg.2020.556520] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 09/02/2020] [Indexed: 01/09/2023] Open
Abstract
Objective To examine body image problems and their associations with disordered eating behavior in adolescents with type 1 diabetes and well-matched healthy peers. Methods Using a cross-sectional design, 183 adolescents with type 1 diabetes (13.02–18.05 years) were recruited from diabetes centers in southern Italy and compared to healthy peers matched for age and gender. Participants completed self-report measures of disordered eating behaviors (DEPS-r and EDI-3RF) and a gender-specific body image problem questionnaire (SATAQ-4R). Socio-demographic and clinical data (zBMI, HbA1c, and disease duration) were also collected. Hierarchical multiple linear regression analyses were computed to determine the relative importance of diabetes variables and body image problems on participants’ disordered eating behaviors after controlling for demographic variables. Results Adolescents with type 1 diabetes showed diabetes-specific eating problems in 37.7% of cases and had more eating problem symptoms (assessed as drive for thinness and bulimia) than healthy peers. Male adolescents with type 1 diabetes did not display more body image problems (p > 0.05); females with type 1 diabetes compared to females in the control group were found to be more pressured by family (p = 0.025) but less by media (p = 0.022) to improve their appearance and attain a thin body. zBMI and body image problems contributed to a significant increase in disordered eating behavior risk both in male and female adolescents with diabetes and in healthy peers (zBMI 0.213 < β < 0.426, p < 0.05; body image 0.243 < β < 0.572, p < 0.05). None of the variables analyzed were found to significantly predict male bulimic symptoms (all β < 0.296, p > 0.05). Conclusion Since in adolescence type 1 diabetes and insulin therapy may increase the risk of weight gain and promote focus and attention on the body and thus contribute to the development of body image problems and disordered eating behaviors, continuity of medical, nutritional, and psychological care is needed.
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Affiliation(s)
- Alda Troncone
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | - Crescenzo Cascella
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | - Antonietta Chianese
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | - Angela Zanfardino
- Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Napoli, Italy
| | - Alessia Piscopo
- Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Napoli, Italy
| | - Anna Borriello
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | - Francesca Casaburo
- Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Napoli, Italy
| | - Emanuele Miraglia Del Giudice
- Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Napoli, Italy
| | - Dario Iafusco
- Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Napoli, Italy
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Troncone A, Cascella C, Chianese A, di Leva A, Confetto S, Zanfardino A, Iafusco D. Psychological support for adolescents with type 1 diabetes provided by adolescents with type 1 diabetes: The chat line experience. Pediatr Diabetes 2019; 20:800-810. [PMID: 31173661 DOI: 10.1111/pedi.12873] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 04/15/2019] [Accepted: 05/29/2019] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Age-specific preventive interventions by exploiting age-appropriate means are needed to effectively support adolescents with type 1 diabetes in facing illness and developmental-related difficulties. The provision of social support through a content analysis of messages posted on online conversations was examined. METHODS Participants and moderators' messages posted to an Italian online chat group for adolescents with type 1 diabetes were content analyzed using a social support behavior coding system. RESULTS Of 250 adolescents approached (aged 12-18), 161 (64.4%) agreed to participate. Seventeen thousand twenty-five individual posts (10 735 written by participants, 6290 by moderators) from 37 chat sessions were examined. Topics concerned management of the disease, diabetes-related problems, nutrition, and the emotional impact of diabetes. Social support was found in 30.64% of the messages (N = 5215). The frequency of supporting messages posted by participants was significantly higher than those written by moderators (X 2 = 20.025, P < .0001). Participants most frequently offered emotional (79.97%) and information support (16.21%), while moderators presented information (52.89%) and emotional support (34.56%). CONCLUSIONS How posting messages in an online group provides an opportunity for adolescents with type 1 diabetes to support each other and help health professionals to learn about the experiences of young individuals is discussed.
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Affiliation(s)
- Alda Troncone
- Department of Psychology, University of Campania Luigi Vanvitelli, Caserta, Italy
| | - Crescenzo Cascella
- Department of Psychology, University of Campania Luigi Vanvitelli, Caserta, Italy
| | - Antonietta Chianese
- Department of Psychology, University of Campania Luigi Vanvitelli, Caserta, Italy
| | - Alfonso di Leva
- Department of Psychology, University of Campania Luigi Vanvitelli, Caserta, Italy
| | - Santino Confetto
- Department of the Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Angela Zanfardino
- Department of the Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Dario Iafusco
- Department of the Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Naples, Italy
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Troncone A, Cascella C, Chianese A, Zanfardino A, Confetto S, Piscopo A, Iafusco D. Parental assessment of disordered eating behaviors in their children with type 1 diabetes: A controlled study. J Psychosom Res 2019; 119:20-25. [PMID: 30947813 DOI: 10.1016/j.jpsychores.2019.02.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 02/03/2019] [Accepted: 02/03/2019] [Indexed: 01/09/2023]
Abstract
OBJECTIVE The purpose of this research is to examine the presence of disordered eating behaviors (DEBs) in youths with type 1 diabetes (T1D) according to their parents' evaluations. The roles of demographic and diabetes-related variables were also analyzed. METHODS In 54 patients with T1D (aged 10.07-15.08) and in 54 age- and gender-matched healthy controls, DEBs were assessed using a parent-report standardized measure. BMI was calculated from height and weight. Glycemic control was assessed based on the most recent glycosylated hemoglobin value (HbA1c). The association of demographic and clinical factors with DEBs was evaluated through correlation and linear regression analyses. RESULTS DEBs were observed more frequently in participants with T1D (33.3%) than in controls (11%) (χ2 = 6.501, p = .04). The clinical sample obtained a higher score than controls in PEBEQ total score (t(106) = 2.464, p = .01), as well as in the Exaggerated interest in food (t(106) = 2.723, p = .008) and Rejection/disinterest in food subscales (t(106) = 2.216, p = .01). No gender differences were observed. In participants with T1D, but not in controls, PEBEQ total score was positively correlated with age (r = 0.203, p = .04), HbA1c (r = 0.335, p = .01), and zBMI (r = 0.298, p = .002); HbA1c (standardized beta =0.284, p = .04) was found to uniquely predict the PEBEQ total score. CONCLUSION Parents' evaluations may contribute to prompt detection of DEBs, which is crucial in developing appropriate strategies for timely intervention, especially during adolescence.
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Troncone A, Chianese A, Zanfardino A, Cascella C, Confetto S, Perrone L, Iafusco D. Nonverbal intelligence and scholastic performance in children with type 1 diabetes. J Health Psychol 2019; 24:229-239. [DOI: 10.1177/1359105317715093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study examined nonverbal intelligence and scholastic achievement in children with type 1 diabetes. In a retrospective case–control study, 69 children (35 males) ages 5–10 years with type 1 diabetes and 69 healthy controls matched to patients by age, gender and socioeconomic status were compared according to their performance on Raven’s Coloured Progressive Matrices and their scholastic grades. No differences in nonverbal intelligence and grades were observed between children with type 1 diabetes and healthy control subjects. Raven’s Coloured Progressive Matrices scores inversely correlated with duration of illness both in children with early onset of type 1 diabetes and poor metabolic control. Possible explanations of the results and implications are discussed.
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Troncone A, Cascella C, Chianese A, Galiero I, Zanfardino A, Confetto S, Perrone L, Iafusco D. Changes in body image and onset of disordered eating behaviors in youth with type 1 diabetes over a five-year longitudinal follow-up. J Psychosom Res 2018; 109:44-50. [PMID: 29773151 DOI: 10.1016/j.jpsychores.2018.03.169] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2017] [Revised: 03/22/2018] [Accepted: 03/23/2018] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To examine changes over a five-year period in body image accuracy and dissatisfaction, as well as relationships with disordered eating behaviors (DEBs), in young patients with type 1 diabetes. METHODS Of 81 children (42 male, 39 female) with type 1 diabetes first assessed at ages 5.1-10.06 years, 67 (83%) were re-enrolled and interviewed as adolescents (aged 10.07-15.08 years) at follow-up. DEBs were assessed using a parent-report standardized measure. Height and weight were determined, and BMI was calculated. Glycemic control was assessed by glycated hemoglobin. RESULTS BMI increased from childhood to adolescence. The general tendency towards body size underestimation (i.e., perceiving the body to be smaller than it is) and dissatisfaction, already described at baseline, was found unchanged at follow-up, revealing continuing attitude towards body image problems. Body-size perception accuracy, degree of body-size dissatisfaction, and HbA1c did not increase significantly over five years, but the presence of DEBs was observed. Degree of body dissatisfaction was found to be a significant predictor for DEBs (standardized beta = 0.272, p < 0.05). CONCLUSION Body image problems persisted over the five-year study period and were found associated with higher levels of DEBs. Identification of such body image characteristics may be useful in developing strategies for intervention early in the course of illness.
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Affiliation(s)
- Alda Troncone
- Department of Psychology, University of Campania "L. Vanvitelli", Italy.
| | | | | | - Ilaria Galiero
- Department of Psychology, University of Campania "L. Vanvitelli", Italy
| | - Angela Zanfardino
- Department of the Women, of the Child, and General, Specialized Surgery, University of Campania "L. Vanvitelli", Italy
| | - Santino Confetto
- Department of the Women, of the Child, and General, Specialized Surgery, University of Campania "L. Vanvitelli", Italy
| | - Laura Perrone
- Department of the Women, of the Child, and General, Specialized Surgery, University of Campania "L. Vanvitelli", Italy
| | - Dario Iafusco
- Department of the Women, of the Child, and General, Specialized Surgery, University of Campania "L. Vanvitelli", Italy
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Troncone A, Cascella C, Zanfardino A, Chianese A, Confetto S, Giglio M, Villano P, Perrone L, Iafusco D. Psychological outcomes of injection port therapy in children and adolescents with type 1 diabetes and their primary caregivers. Acta Diabetol 2017; 54:975-978. [PMID: 28597351 DOI: 10.1007/s00592-017-1014-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Accepted: 06/01/2017] [Indexed: 11/26/2022]
Affiliation(s)
- Alda Troncone
- Department of Psychology, University of Campania "Luigi Vanvitelli", Viale Ellittico 31, Caserta, Italy.
| | - Crescenzo Cascella
- Department of Psychology, University of Campania "Luigi Vanvitelli", Viale Ellittico 31, Caserta, Italy
| | - Angela Zanfardino
- Department of the Woman, of the Child and of the General and Specialistic Surgery, University of Campania "Luigi Vanvitelli", Regional Centre of Paediatric Diabetology "G.Stoppoloni", Via Luigi De Crecchio, 2, Naples, Italy
| | - Antonietta Chianese
- Department of Psychology, University of Campania "Luigi Vanvitelli", Viale Ellittico 31, Caserta, Italy
| | - Santino Confetto
- Department of the Woman, of the Child and of the General and Specialistic Surgery, University of Campania "Luigi Vanvitelli", Regional Centre of Paediatric Diabetology "G.Stoppoloni", Via Luigi De Crecchio, 2, Naples, Italy
| | - Milena Giglio
- Department of Psychology, University of Campania "Luigi Vanvitelli", Viale Ellittico 31, Caserta, Italy
| | - Pasquale Villano
- Department of the Woman, of the Child and of the General and Specialistic Surgery, University of Campania "Luigi Vanvitelli", Regional Centre of Paediatric Diabetology "G.Stoppoloni", Via Luigi De Crecchio, 2, Naples, Italy
| | - Laura Perrone
- Department of the Woman, of the Child and of the General and Specialistic Surgery, University of Campania "Luigi Vanvitelli", Regional Centre of Paediatric Diabetology "G.Stoppoloni", Via Luigi De Crecchio, 2, Naples, Italy
| | - Dario Iafusco
- Department of the Woman, of the Child and of the General and Specialistic Surgery, University of Campania "Luigi Vanvitelli", Regional Centre of Paediatric Diabetology "G.Stoppoloni", Via Luigi De Crecchio, 2, Naples, Italy
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Esposito A, Esposito AM, Troncone A, Cordasco G, Orlandini A, Tsoukalas L. Editorial. INT J ARTIF INTELL T 2017. [DOI: 10.1142/s0218213017020018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Anna Esposito
- Università degli Studi della Campania “Luigi Vanvitelli”, Dipartimento di Psicologia, Viale Ellittico n. 31, 81100 Caserta, Italy
| | - Antonietta M. Esposito
- Istituto Nazionale di Geofisica E Vulcanologia, Sezione di Napoli, Osservatorio Vesuviano, Napoli, Italy
| | - Alda Troncone
- Università degli Studi della Campania “Luigi Vanvitelli”, Dipartimento di Psicologia, Viale Ellittico n. 31, 81100 Caserta, Italy
| | - Gennaro Cordasco
- Università degli Studi della Campania “Luigi Vanvitelli”, Dipartimento di Psicologia, Viale Ellittico n. 31, 81100 Caserta, Italy
| | - Andrea Orlandini
- Consiglio Nazionale delle Ricerche, Istituto di Scienze e Tecnologie della Cognizione (CNR-ISTC), Via S. Martino della Battaglia 44 I-00185, Roma, Italia
| | - Lefteris Tsoukalas
- Applied Intelligent Systems Lab (AISL), Purdue University, 400 Central Drive, West Lafayette, Indiana, USA
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Troncone A, Bonfanti R, Iafusco D, Rabbone I, Sabbion A, Schiaffini R, Galderisi A, Marigliano M, Rapini N, Rigamonti A, Tinti D, Vallone V, Zanfardino A, Boscari F, Del Favero S, Galasso S, Lanzola G, Messori M, Di Palma F, Visentin R, Calore R, Leal Y, Magni L, Losiouk E, Chernavvsky D, Quaglini S, Cobelli C, Bruttomesso D. Evaluating the Experience of Children With Type 1 Diabetes and Their Parents Taking Part in an Artificial Pancreas Clinical Trial Over Multiple Days in a Diabetes Camp Setting. Diabetes Care 2016; 39:2158-2164. [PMID: 27852685 DOI: 10.2337/dc16-1073] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Accepted: 09/08/2016] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To explore the experiences of children with type 1 diabetes and their parents taking part in an artificial pancreas (AP) clinical trial during a 7-day summer camp. RESEARCH DESIGN AND METHODS A semistructured interview, composed of 14 questions based on the Technology Acceptance Model, was conducted at the end of the clinical trial. Participants also completed the Diabetes Treatment Satisfaction Questionnaire (DTSQ, parent version) and the AP Acceptance Questionnaire. RESULTS Thirty children, aged 5-9 years, and their parents completed the study. A content analysis of the interviews showed that parents were focused on understanding the mechanisms, risks, and benefits of the new device, whereas the children were focused on the novelty of the new system. The parents' main concerns about adopting the new system seemed related to the quality of glucose control. The mean scores of DTSQ subscales indicated general parents' satisfaction (44.24 ± 5.99, range 32-53) and trustful views of diabetes control provided by the new system (7.8 ± 2.2, range 3-12). The AP Acceptance Questionnaire revealed that most parents considered the AP easy to use (70.5%), intended to use it long term (94.0%), and felt that it was apt to improve glucose control (67.0%). CONCLUSIONS Participants manifested a positive attitude toward the AP. Further studies are required to explore participants' perceptions early in the AP development to individualize the new treatment as much as possible, and to tailor it to respond to their needs and values.
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Affiliation(s)
- Alda Troncone
- Department of Psychology, Second University of Naples, Caserta, Italy
| | - Riccardo Bonfanti
- Pediatric Department and Diabetes Research Institute, Scientific Institute, Hospital San Raffaele, Milan, Italy
| | - Dario Iafusco
- Department of the Woman, of the Child and of the General and Specialized Surgery, Second University of Naples, Naples, Italy
| | - Ivana Rabbone
- Department of Pediatrics, University of Turin, Turin, Italy
| | - Alberto Sabbion
- Regional Center for Pediatric Diabetes, Pediatric Diabetes and Metabolic Disorders Unit, Azienda Ospedialiera Universitaria Integrata of Verona, Verona, Italy
| | - Riccardo Schiaffini
- Unit of Endocrinology and Diabetes, Bambino Gesù, Children's Hospital, Rome, Italy
| | - Alfonso Galderisi
- Department of Woman's and Child's Health, University of Padua, Padua, Italy
| | - Marco Marigliano
- Regional Center for Pediatric Diabetes, Pediatric Diabetes and Metabolic Disorders Unit, Azienda Ospedialiera Universitaria Integrata of Verona, Verona, Italy
| | - Novella Rapini
- Pediatric Diabetology Unit, Policlinico di Tor Vergata, University of Rome Tor Vergata, Rome, Italy
| | - Andrea Rigamonti
- Pediatric Department and Diabetes Research Institute, Scientific Institute, Hospital San Raffaele, Milan, Italy
| | - Davide Tinti
- Department of Pediatrics, University of Turin, Turin, Italy
| | - Valeria Vallone
- Unit of Metabolic Diseases, Department of Internal Medicine, University of Padova, Padova, Italy
| | - Angela Zanfardino
- Department of the Woman, of the Child and of the General and Specialized Surgery, Second University of Naples, Naples, Italy
| | - Federico Boscari
- Unit of Metabolic Diseases, Department of Internal Medicine, University of Padova, Padova, Italy
| | - Simone Del Favero
- Department of Information Engineering, University of Padova, Padova, Italy
| | - Silvia Galasso
- Unit of Metabolic Diseases, Department of Internal Medicine, University of Padova, Padova, Italy
| | - Giordano Lanzola
- Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy
| | - Mirko Messori
- Department of Civil Engineering and Architecture, University of Pavia, Pavia, Italy
| | - Federico Di Palma
- Department of Civil Engineering and Architecture, University of Pavia, Pavia, Italy
| | - Roberto Visentin
- Department of Information Engineering, University of Padova, Padova, Italy
| | - Roberta Calore
- Department of Information Engineering, University of Padova, Padova, Italy
| | - Yenny Leal
- Department of Information Engineering, University of Padova, Padova, Italy
| | - Lalo Magni
- Department of Civil Engineering and Architecture, University of Pavia, Pavia, Italy
| | - Eleonora Losiouk
- Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy
| | - Daniel Chernavvsky
- Center for Diabetes Technology, University of Virginia, Charlottesville, VA
| | - Silvana Quaglini
- Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy
| | - Claudio Cobelli
- Department of Information Engineering, University of Padova, Padova, Italy
| | - Daniela Bruttomesso
- Unit of Metabolic Diseases, Department of Internal Medicine, University of Padova, Padova, Italy
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Troncone A, Cascella C, Chianese A, Iafusco D. Using computerized text analysis to assess communication within an Italian type 1 diabetes Facebook group. Health Psychol Open 2015; 2:2055102915615338. [PMID: 28070379 PMCID: PMC5193317 DOI: 10.1177/2055102915615338] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The purpose of this study was to assess messages posted by mothers of children with type 1 diabetes in the Italian Facebook group “Mamme e diabete” using computerized text analysis. The data suggest that these mothers use online discussion boards as a place to seek and provide information to better manage the disease’s daily demands—especially those tasks linked to insulin correction and administration, control of food intake, and bureaucratic duties, as well as to seek and give encouragement and to share experiences regarding diabetes and related impact on their life. The implications of these findings for the management of diabetes are discussed.
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Affiliation(s)
| | | | | | - Dario Iafusco
- Department of the Woman, of the Child and of the General and Specialized Surgery, Second University of Naples, Naples, Italy
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Abstract
There has been some ongoing debate on whether the DAP:QSS can be used to measure intelligence. The purpose of this study was to evaluate the concurrent validity of the DAP:QSS with Raven's Coloured Progressive Matrices (RCPM) and the DAP:QSS's accuracy as a predictor of RCPM scores and academic achievement. 184 children from two elementary schools in a region of Southern Italy was evaluated by the DAP:QSS, the RCPM, the Goodenough-Harris Drawing Test (GH), and school marks. Drawings' scores, school marks, and RCPM scores were subjected to a Pearson's correlation. Stepwise regression analyses were carried out to identify significant predictors of RCPM scores and school marks. After controlling for socioeconomic status, the DAP:QSS showed a significant correlation with the RCPM and GH tests and academic achievement. However, the modest correlations with the RCPM, the small amount of variance in RCPM scores accounted for by the DAP:QSS (R(2) = .24), and the errors of the DAP:QSS in correctly classifying participants with borderline/deficient intellectual functioning advise against the use of the DAP:QSS as a measure of intelligence.
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Affiliation(s)
- Alda Troncone
- 1 Department of Psychology, Second University of Naples, Italy
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Troncone A, Prisco F, Cascella C, Chianese A, Zanfardino A, Iafusco D. The evaluation of body image in children with type 1 diabetes: A case-control study. J Health Psychol 2014; 21:493-504. [DOI: 10.1177/1359105314529682] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This study evaluated the body image perception in children with type 1 diabetes in order to identify symptoms of disordered eating behaviours early. Children with type 1 diabetes and controls showed underestimation and dissatisfaction with body size. The patients, especially girls, were more accurate in their perception of body size than the control group. The study sheds light on some of the underlying factors that may contribute to the development of disordered eating behaviours in adolescence. The causes of the differences of perception of body size are discussed.
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Perillo A, Passantino G, Passantino L, Cianciotta A, Mastrosimini AM, Lacovazzi P, Venezia P, Jirillo E, Troncone A. First Observation of an Hashimoto Thyroiditis-Like Disease in Horses from Eastern Europe: Histopathological and Immunological Findings. Immunopharmacol Immunotoxicol 2008; 27:241-53. [PMID: 16114508 DOI: 10.1081/iph-200067743] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Among 622 slaughtered horses from eastern Europe, 156 thyroid glands were selected on the basis of macroscopic alterations (e.g., determination of volume and weight). In the 80% of these thyroids, microscopic alterations consistent with a diagnosis of Hashimoto thyroiditis-like disease were found. In particular, a subverted architecture of the thyroid gland with colloid rarefaction, lymphocytic infiltration, and fibrosis was noted. The confirmation of the histopathological diagnosis of an equine Hashimoto thyroiditis-like disease was provided by the increased serum concentration of thyroglobulin, of antithyroglobulin, and of antithyroid peroxidase autoantibodies. Despite evidence consistent with an Hashimoto thyroiditis-like disease in eastern European horses, the etiopathogenesis of this autoimmune disorder deserves further investigation. In this respect, in some horses histopathological alterations in the pituitary gland may suggest an as-yet-unidentified disorder within the hypothalamus-pituitary adrenal axis associated with Hashimoto thyroiditis.
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Affiliation(s)
- A Perillo
- Department of Animal Health and Welfare, Faculty of Veterinary Medicine, University of Bari, Bari, Italy
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Abstract
The study evaluated the illness behavior of patients with celiac disease and the influence of the disease and its treatment on key personality components and adherence to dietary recommendations. Twenty-nine adult patients with celiac disease and 47 matched healthy comparison subjects participated in the study. More than 70% of the celiac disease group scored in the pathological range on at least one scale of the Illness Behavior Questionnaire. Patients who received the diagnosis in adulthood had a lower score for nonconformism, a greater tendency to pretend to be sociable, and higher levels of psychophysiological reactiveness, relative to the comparison subjects. The results suggest that celiac disease may be associated with changes in personality that may interfere with patients' adaptation to living with a chronic disease.
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Affiliation(s)
- Antonio de Rosa
- Psychiatry Department, Second University of Naples, Naples, Italy
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Lombardi V, Shnaar R, Minev B, Misasi R, Gitstsi K, Sorice M, Troncone A. Conjugates of aberrant gangliosides in antiglioma vaccine: toxicological assay. Bull Exp Biol Med 2002; 134:363-5. [PMID: 12533760 DOI: 10.1023/a:1021908331236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2002] [Indexed: 11/12/2022]
Abstract
We studied sterility and toxicity of vaccine LS1 containing aberrant gangliosides isolated from brain bioptates of 48 patients with gliomas of different malignancy and covalently bound to keyhole limpet hemocyanin. The vaccine was safe. This preparation produced no side effects in experimental animals. Our findings substantiated the necessity of father development of this method of vaccination. The vaccine should undergo clinical tests in patients with malignant gliomas.
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Affiliation(s)
- V Lombardi
- University of Bari, Institute of Pathological Anatomy, Italy.
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Lombardi V, Valko L, Stolc S, Valko M, Ondrejicková O, Horáková L, Placek J, Troncone A. Free radicals in rabbit spinal cord ischemia: electron spin resonance spectroscopy and correlation with SOD activity. Cell Mol Neurobiol 1998; 18:399-412. [PMID: 9619295 DOI: 10.1023/a:1022597431593] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
1. In nonanesthetized rabbits temporal occlusion of the abdominal aorta was used to induce oxidative stress in the lower part of the body including distal segments of the spinal cord. 2. Spinal cord samples were taken from the animals exposed to 25-min aortic occlusion (AO) or to occlusion followed by 1- or 2-hr reperfusion (AO/R1 or AO/R2, respectively) or from sham-operated animals (C). The presence of free radicals (FR) in the spinal cord samples frozen in liquid N2 was assessed by ESR spectroscopy without spin trapping. Moreover, superoxide dismutase (SOD) activity and conjugated diene (CD) levels were measured in the samples. 3. In the AO group FR were detected in the spinal cord regions close to the occlusion (lower thoracic and distal segments) along with a decrease in SOD activity. The calculated g value (g = 2.0291) indicated that the paramagnetic signal recorded might be attributed to superoxide radicals. FR were absent in the AO/R1 group. Concurrently, the SOD activity revealed a significant tendency to return to the control level. FR appeared again in the AO/R2 group, mostly in the upper and middle lumbar regions, along with a decrease in SOD activity. No sample from the C group revealed FR. A significant increase in CD levels was observed in the thoracolumbar region only in the AO/R2 group. The temporary absence of FR in the AO/R1 group suggests activation of defense antioxidant mechanisms (e.g., specific enzymatic systems such as SOD), which might have been exhausted later. 4. Changes in SOD activity similar to those observed in the thoracolumbar region, though less noticeable, occurred in the obviously noncompromised tissue (upper cervical region). This points to a kind of generalized response of the animal to aortic occlusion. 5. Direct ESR spectroscopy revealed the presence of FR as well as their time course in the spinal cord during the early phase of ischemia/reperfusion injury and the inverse relationship between FR and SOD activity.
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Affiliation(s)
- V Lombardi
- Department of Pathological Anatomy, Bari Oncology Center, Italy
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Lombardi V, Valko L, Valko M, Scozzafava A, Morris H, Melnik M, Svitel J, Budesinský M, Pelnár J, Steno J, Liptaj T, Zalibera L, Budinská J, Zlatos J, Giuliani A, Mascolo L, Leibfritz D, Troncone A, Marzullo F, Mazur M, Klener J, Zverina E. 1H NMR ganglioside ceramide resonance region on the differential diagnosis of low and high malignancy of brain gliomas. Cell Mol Neurobiol 1997; 17:521-35. [PMID: 9353593 DOI: 10.1023/a:1026362922549] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
1. The high-resolution 1H NMR (MRS) spectra of human brain tumor homogenates revealed a broad resonance at 5.3-5.4 ppm in glioblastoma multiforme (N = 16) and brain metastases (N = 3). The broad resonance was identified as ceramide, a sphingosine-fatty acid combination portion of ganglioside, indicating an elevated abundance of monounsaturated fatty acids. GLC analysis of gangliosides in the highly malignant glioblastoma multiforme revealed that the elevated monounsaturated fatty acid is oleic acid (C18:1). The resonance at 5.3-5.4 ppm region was not detectable in normal human brain (N = 2), in meningiomas (N = 2), or in low-grade astrocytomas (N = 12). In normal human brain the abundance of monounsaturated fatty acid is minimal. 2. This investigation was made possible because the method of producing homogenate resulted in (i) no loss of lipids during the process and (ii) a well-homogenised sample, with (iii) no loss in chemical integrity. 3. The properties of tumor gangliosides include antigenic specificity and immunosuppressive activity and the ceramide, a sphingosine-fatty acid combination, noticeably influences the ganglioside immunosuppressive activity. 4. The observation of 1H NMR ceramide resonance in high-malignant brain tumors emphasizes the dramatic role of aberant gangliosides and ceramide precursors on the grade of malignancy and invasiveness. 5. Further insight into the specific nature of the ceramide portion of gangliosides in grading the malignancy of brain tumors should be investigated further.
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Affiliation(s)
- V Lombardi
- Department of Pathological Anatomy, Oncology Center of Bari, Italy
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Abstract
Two cases of extrathoracic silicosis in buffaloes raised near a quartz quarry and suffering from clinically severe silicosis are described. The extrapulmonary changes were characterized by silicoconiotic nodules in the tonsils, mesenteric lymph nodes and spleen. A combination of energy dispersive X-ray microanalysis and scanning electron microscopy revealed that the mineral component of these lesions consisted mainly of silicon, aluminium, iron, calcium, magnesium, zinc, sulphur and potassium. It is concluded that domestic animals raised in polluted environmental conditions represent an important biological source from which helpful data may be obtained for assessing risks to human health and gaining new insight into pathogenetic mechanisms.
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Affiliation(s)
- F Roperto
- Department of Veterinary Pathology, Naples University Federico II, Italy
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31
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Roperto F, Galati P, Troncone A, Rossacco P, Campofreda M. Primary ciliary dyskinesia in pigs. J Submicrosc Cytol Pathol 1991; 23:233-6. [PMID: 2070349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The first description of a familial immotile cilia syndrome diagnosed through ovario-hysterectomy in six siblings of pigs has been performed. This report may indicate another possible cause of reproductive failure in domestic animals. In fact, the immotile cilia syndrome has not been considered from this point of view in veterinary medicine. This case emphasizes that a study about ciliary motility in the female reproductive tract in domestic animals is absolutely necessary to improve current knowledge about different causes of infertility. Up to date, it remains unknown what degree of ciliary motility is necessary for mammalian fertility in females.
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Affiliation(s)
- F Roperto
- Department of Veterinary Pathology, Faculty of Veterinary Medicine, University Federico II, Naples, Italy
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Branno P, Farinella R, Fontana B, Troncone A, Tufano A, Varriale O. La Terapia Della Colica Renale: Antispastici versus Antiprostaglandino-Sintetasi. Urologia 1986. [DOI: 10.1177/039156038605300507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Pesino L, Troncone A. [Detection of Salmonella in the rumen content of cattle destined for sale on the market]. Riv Ital Ig 1967; 27:488-91. [PMID: 5629595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Troncone A, Giordano A, Ferrari GF, Catellani G. [Studies of the presence of carotenoids in stored fat in the buffalo (Bubalus buffalus)]. Acta Med Vet (Napoli) 1966; 12:509-14. [PMID: 5999475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Troncone A, Damiano S, Ferrari GF, Catellani G. [Study of the carotenoids in stored fat in swine]. Acta Med Vet (Napoli) 1966; 12:595-7. [PMID: 5999480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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